Childbirth notes 1.txt

First trimester-decrease; second and third-increase; labor and postpartum decrease

PTL, tissue injury or hemorrhage, preeclampsia, infections, ketoacidosis, polyhyadramnios, hyperglycemia and hypoglycemia

fetus death (IUFD), congenital malformations, fetal macrosomnia, birthinjuries, neonatal hypoglycemia

growth hormone causing the fetus to produce excess glycogen, protein and adipose tissue and leading to increased fetal size

heart cannot maintain sufficient cardiac output. Increased SOB, abnormal breath sounds, fatigue, faint, edema

anticoagulants, antidysrhythmics, antiinfectives, drugs for HF, pain meds to reduce cardiac workload and reduce risk of tachy; avoid abrupt positional changes, vaginal birth, O2

Side with head and shoulders elevated

reduces blood’s oxygen carrying capacity, increases the heart’s workload and can lead to CHF; reduces the woman’s abilify to tolerate blood loss during birth and increases risk of complications such as infection

good prenatal care, folic acid supplementation, frequent labs, check for infections, fetal surveillance to detect growth, transfusion may be necessary

should only take one anticonvulsant med at lowest dose that is effective; meds can cause neural tube defects

consult with neuro pre pregnancy, reduce adverse effects of anticonvulsants in fetus, prevent generalized seizures (dark, cool room; side rails up), assist with fetal monitoring

usually postponed until after delivery

if woman has obstructive jaundice, gallstone pancreatitis or suspected peritonitis

tremors, exaggerated moro reflex, IUGR

placental abruption, PTL, precipitous birth, tremulousness, irritability, poor feeing, hyperactivity to environmental stimuli

PTL, LBW, abnormal sleep, agitation, IUGR, small head, hemorrhage, < nutrient supply, agitation, diaphoresis

IUGR, PROM, infection, breech, PTL, hypoxia in utero, SAB, stillbirth, meconium aspiration, increased risk for SIDS

decrease placental perfusion and low birth weight

leading cause of mental retardation and birth defects

neonate’s size

hemolysis, elevated liver enzymes, low platelets

given to baby to help improve lungs

sudden increase in intraabdominal pressure including a seizure could lead to rupture of a subcapsular hematoma resulting in internal bleeding and hypovolemic shock

control BP

if gestation is >34 weeks

if gestation is less than 34 weeks

ABD in HELLP

monitor BP, assess wt, I/O, labs, JVD, cap refill, peripheral pulses, CHF, temp

hyperactive DTRs, headache, altered LOC, edema, visual changes bleeding

causes widespread external or internal bleeding and clotting